OB/ peds exam 6

23) Which is the most appropriate assessment question for the nurse to ask when collecting nutritional data from an adolescent client?

1. "How do you feel about your weight and the way you look?"

12) The nurse is teaching the parents of a toddler-age child information regarding toy and playground safety. Which parental statement indicates the need for further education?

1. "I allow my child to play with the packaging material for new toys."

11) The nurse is conducting an educational program for parents of children with chronic conditions. Which parental statement indicates the need for further instruction?

1. "I know my child will get better and not have to take any more medication."

10) The nurse is teaching the parents of a toddler-age child about injury prevention. Which statement by the parent indicates the need for further education?

1. "I will turn the handles of the pots outward while I am cooking dinner."

17) Which assessment questions are appropriate when the nurse is assessing the mental health of a preschool-age client? Select all that apply.

1. "Is your child experiencing nightmares?" 2. "Does your child ask questions about the genitalia?" 3. "How do you implement punishment for your child when a rule is broken?"

10) A mother reports that her adolescent daughter is always late. The mother states, "She was born late and has been late every day of her life." Which response by the nurse is appropriate?

1. "Setting specific alarms and then reinforce the value of being 'on-time' may be helpful strategies to assist her to be more of an 'on-time' individual."

1) Which pediatric client will the community health nurse assess first?

1. A 6-year-old who is wheezing and short of breath.

13) The nurse is caring for a 17-year-old client with a chronic condition who will be transitioning into adulthood. When planning care for this client, which should the nurse consider? Select all that apply.

1. Ability to work 2. Ability to live independently 3. Psychosocial needs

2) The nurse is providing care to several hospitalized pediatric clients. Which child has the greatest risk for a developmental disability?

1. An 18-month-old admitted with a diagnosis of near drowning

18) The nurse is preparing to collect data for a family assessment. Which nursing actions are appropriate? Select all that apply.

1. Conducting interviews 2. Observing interactions 3. Reviewing reports from the healthcare provider 4. Monitoring daily living patterns

10) Which actions are expected for a nurse who works in the school environment? Select all that apply.

1. Developing a plan for emergency care of injured children 2. Teaching a class on wellness to teachers and staff 5. Screening for head lice

26) The nurse provides care to pediatric clients with chronic disease process. Which diagnoses does the nurse categorize as dependent on medications or special diets? Select all that apply.

1. Diabetes mellitus 2. Epilepsy 3. Celiac disease

27) The school nurse is planning an education program for fourth-grade children regarding prepubescent changes. What nursing action will make the educational program successful?

1. Discussing program content with the parents

16) Which are resources that enable families to develop and adapt to stressors? Select all that apply.

1. Education 3. Prior experiences 5. Adequate finances

8) The nurse is planning care for the family of a child with a chronic illness. Which activities will the nurse recommend to decrease the risk for compassion fatigue? Select all that apply.

1. Fostering social relationships 2. Exercising 3. Developing a hobby

26) Which will the nurse include in the assessment process for a school-age child who is exhibiting poor school performance? Select all that apply.

1. Hearing screen 2. Muscle tone 4. Vision screen

15) Which screenings are appropriate for an adolescent client who admits to being sexually active during a scheduled health maintenance visit? Select all that apply.

1. Herpes simplex virus 2. Gonorrhea 3. Chlamydia

1) The nurse is providing care to a pediatric client who is experiencing separation anxiety. Which data would support the documentation of the "despair" phase?

1. Lies quietly in bed.

1) The nurse develops and implements a health promotion plan for an adolescent client. What should the nurse include in the evaluation of the plan?

1. Methods to expand and sustain successful approaches

3) The parents of a child who is critically injured wish to stay in the room while the child is receiving emergency care. Which nursing action is most appropriate in this situation?

2. Allowing the parents to stay with the child

7) The nurse is assessing an adolescent patient during a scheduled health maintenance visit. The adolescent's mother is currently in the examination room with the patient. Which topic should the nurse avoid until the mother has left the examination room?

2. Cigarette smoking

3) The nurse is planning care for a school-age child who requires oxygen, enteral tube feedings, and IV medications during the school day. To which category of chronic illness does this child belong?

2. Dependent on medical technology

14) Which nursing action is best when teaching adolescent health promotion and health maintenance topics?

2. Having the adolescents identify a personal health goal

14) The nurse is providing care to a toddler-age client newly diagnosed with a chronic condition. Which nursing action will prepare the family for providing care to the toddler once discharged from the hospital setting?

2. Helping the parents recognize their child's capabilities

22) The nurse is planning care for an adolescent whose parents have both recently been laid off from their jobs. Which is the priority diagnosis for the adolescent and family?

2. Imbalanced Nutrition: Less Than Body Requirements

14) Which action should the nurse include when providing education regarding methods to enhance health promotion during a scheduled health maintenance visit for a 4-year-old child?

2. Involving the child in snack selection and preparation

19) Which teaching topics are appropriate for the nurse to include for an adolescent who admits to the use of chewing tobacco? Select all that apply.

2. Nicotine addiction 3. Mouth cancers 5. Mouth ulcers

6) The following information is collected during the nursing assessment: the adolescent's menses began when she was 12 years old; a current body mass index (BMI) of 27.5; inconsistent school performance over the last several years. Which is the priority area of teaching for this adolescent?

2. Nutritional intake

6) The parents of a 2-year-old girl inquire about information to help their child transition to bed each night. Which response by the nurse is appropriate?

3. Read a book to the child just before bedtime each night.

4) Which nursing action is appropriate when providing care to an adolescent client who is accompanied to an appointment by a parent?

3. Reassuring the parent that the nurse will discuss any parental concerns or questions after the examination

2) Which is a common fear, in addition to separation anxiety, for the hospitalized pediatric client between the ages of 6 and 18 months?

3. Stranger anxiety

4) Which action by the nurse is appropriate when teaching the parents of a 2-year-old child during a scheduled health maintenance visit?

3. Teaching the parents that it is appropriate to switch from whole to 2% milk

28) During the psychosocial portion of the nursing assessment a school-age child states, "I know I am not as good as them, so I just play by myself at recess every day." Which conclusion by the nurse is accurate?

3. The child has decreased self-esteem.

17) The school nurse is reviewing the records of all incoming kindergarten students. Which students will require an individualized education plan (IEP)?

3. The child with a hearing deficit 4. The child with autism spectrum disorder 5. The child with an IQ of 60

27) The nurse provides care to pediatric clients with chronic disease process. Which diagnoses does the nurse categorize as needing increased use of healthcare services? Select all that apply.

1. Cancer 2. Sickle cell disease 4. Cystic fibrosis

19) The mother of an adolescent with multiple medical and developmental issues says to the nurse: "There are times that I think about just walking out of the house and not coming back." Which would be an appropriate nursing diagnosis for this mother?

1. Caregiver Role Strain related to providing 24-hour care for a child with medical and developmental issues

16) Which will the nurse assess in the family of a 3-year-old child during a pediatric clinic visit scheduled due to regressive behavior? Select all that apply.

1. Change in parental marital status 3. Health of child's siblings 4. Maternal depression

16) The nurse works in a clinic for medically fragile children who require home care. The nurse has noticed that a high percentage of the families parents divorce. In an attempt to reduce the divorce rate among the parents, the nurse creates an educational session for parents of medically fragile children. Which should be the focus of this session?

1. Communication

18) Which nursing actions are appropriate when conducting a mental health assessment for a toddler-age child? Select all that apply.

1. Observing the child's interaction with family members 2. Asking the caregiver to describe the child's typical day 3. Giving the child a crayon to assess ability to use 4. Determining the number of hours the child sleeps each night

5) A school nurse is performing annual height and weight screening. The nurse notes that three adolescent girls who are close friends each lost 15 pounds over the past year. Which is the priority nursing action?

1. Obtaining a nutritional history for each of these adolescents

20) The pediatric nurse is working as a first responder within the community after a tornado. Which nursing actions are appropriate? Select all that apply.

1. Providing first aid to the walking wounded 2. Assessing for panic reactions 4. Administering immunizations

20) Which recommendations will the nurse make to the parents of a preschool-age child who is experiencing frequent nightmares? Select all that apply.

1. Reassure the child by back rubbing. 2. Repeat a nighttime routine, such a reading a story. 4. Allow the child time to settle back into sleep.

25) The nurse of the family who is assuming the role of care coordinator is providing education regarding the use of a healthcare log. Which will the nurse encourage the family to include on this log? Select all that apply.

1. Role of each provider 2. Date of each appointment 3. Prescribed interventions 4. Future treatments

19) The nurse is constructing a genogram as part of the family assessment process. Which will the nurse include in the genogram? Select all that apply.

1. Social class 2. Occupation 3. Place of residence 5. Ethnicity

17) Which nursing actions will allow a family to further develop resilience when faced with an illness of a child? Select all that apply.

1. Teaching skills to provide care 2. Suggesting adaptations related to discipline 3. Providing positive reinforcement

3) Which should the nurse keep in mind when providing care to an adolescent client during the initial visit?

1. The importance of explaining procedures and introducing personnel to adolescents.

19) Which interventions will the nurse recommend for a toddler-age client who is biting other children at daycare? Select all that apply.

1. Using a time-out as a form of discipline for the child's behavior 2. Separating the child from the situation 3. Telling the child it is not okay to hurt another person 4. Inquiring whether the child is getting enough sleep

24) The nurse care coordinator is supporting a family who wishes to become their child's care coordinator. Which statements will the nurse include in the teaching session to prepare the family for this task? Select all that apply.

2. "Care coordination requires ongoing assessment of your child's needs." 4. "Care coordination requires you to be educated regarding your child's diagnosis." 5. "There is a care coordination workshop provided by hospital educators that will help you to learn this role."

15) The nurse is developing an ecomap for a pediatric client and family. Which explanation should the nurse provide prior to beginning this task?

2. "It illustrates your family relationships and interactions with community activities including school, parental jobs, and children's activities."

20) Which question is appropriate for the nurse to include in the assessment for an adolescent client related to developmental tasks?

2. "What type of relationship do you have with your friends?

4) The pediatric group is providing care to a group of hospitalized clients. Which client is at the greatest risk for developing separation anxiety if the parents are unable to stay with the child at all times?

2. 18 month old

At which age will the nurse begin to calculate body mass index (BMI) as a part of the nursing assessment process?

2. 18 months

5) A 2-month-old infant with bronchopulmonary dysplasia (BPD) is being prepared for discharge from the neonatal intensive care unit. The infant will continue to receive oxygen via nasal cannula at home. Prior to discharge, the home health nurse assesses the home. Which finding poses the greatest risk to this infant?

2. A wood stove used for heating

13) The nurse is planning to teach a group of adolescents about what can happen when having unprotected sex. Which nursing action will allow effective communication with the group?

2. Allowing for discussion among the participants

15) After the infant is diagnosed with a chronic health condition, the family is assigned a nurse case manager. Which will the nurse include in the explanation to the infant's parents regarding this role?

2. Preventing duplication of services 3. Improving the quality of life for the child and parents 4. Recognizing the equipment needs of the child and providing assistance with equipment acquisition

12) During a health maintenance visit an adolescent states, "I have no friends in my new school, and I no longer want to go to college. I know I will be lonely there, too." Which is the priority nursing action?

2. Promoting healthy mental health outcomes

2) The nurse is assessing an adolescent client to determine relationships with others. Which nursing action is appropriate?

2. Providing separate time to communicate with both the adolescent and the parents

22) The parents of a 4-month-old child learn that there will be long-term consequences due to the head injury sustained in a motor vehicle accident, including intellectual disability and cerebral palsy. The parents express anger at the diagnosis and project that anger on the nursing staff. Which responses by the nursing staff are appropriate? Select all that apply.

2. Recognizing that the parents' anger is a normal response to the news 3. Continuing to provide physical and emotional care to the child and family 4. Offering hospital resources to the parents in addition to continued nursing support

4) The home health nurse is providing care to a 2-week-old newborn, and notes that the baby has a necklace with a charm around the neck. The parents state that they believe the charm will keep the baby healthy. Which nursing action is most appropriate?

2. Respect the parents' wishes and leave the necklace in place.

5) The nurse is providing care to a pediatric client who is newly diagnosed with a chronic condition. The parents ask, "When will our child be able to assume more responsibility for managing the disease?" Which age group will the nurse include in the response to the parents?

2. School-age

7) The nurse is working with the parents of a child with a chronic condition. Which statement made by the child's parents indicates the need for intervention related to overwhelming caregiver burden?

3. "I have to care for my child day and night, which leaves little time for me."

9) An obese adolescent who adamantly denies sexual activity has a positive pregnancy test. Which response by the nurse is most appropriate?

3. "Let's discuss some activities that you have done within the past few months that could possibly lead to pregnancy."

8) Which parental statement during a scheduled health maintenance assessment for a preschool-age child would cause the nurse concern?

3. "Our child wakes up each night screaming because of nightmares."

11) Which assessment finding for a toddler-age child indicates an increased risk for an unhealthy self-concept?

3. A parent who is observed spanking a child for taking a toy from another child in the waiting room

12) A child who is dependent on a ventilator is being discharged from the hospital. Which will the nurse recommend for the emergency plan of care for this family during the discharge instruction process?

3. Acquiring a backup generator

9) The telephone triage nurse receives a call from a parent who describes a crowing sound when the 18-month-old breathes and the child is hard to wake up. Which is the appropriate nursing action?

3. Advising the parent to hang up and call 911

15) The nurse is conducting a physical assessment for a preschool-age child. When plotting the child's body mass index (BMI) the nurse notes that the child's is at the 90th percentile. Which action by the nurse is appropriate?

3. Assessing the child's level of activity

9) The nurse observes that over time, the parents of a child with a chronic condition have experienced a pattern of periodic grieving alternating with denial. Which will the nurse include in the child's updated plan of care?

3. Chronic Sorrow

29) An overweight school-age girl states, "I would like to be more active but my parents won't let me try out for the soccer team." Which is an appropriate nursing action based on this statement?

3. Encouraging the parents to investigate the option of ride sharing with a classmate's family

24) A nurse obtains a nutritional health history from a 10-year-old child. Which food increases the risk for dental caries necessitating education regarding oral hygiene?

3. Gummy bears and licorice

6) Which does the nurse include in the plan of care for an adolescent with a chronic condition?

3. Having an altered body image

4) The nurse is partnering with the family of a hospitalized premature neonate who suffered an intraventricular hemorrhage (IVH). After 3 months in the neonatal intensive care unit (NICU), the infant is being discharged. Which activities will the nurse suggest to the family to help stimulate the infant's development? Select all that apply.

3. Holding and rocking the infant 4. Interacting face to face 5. Talking softly and singing to the infant

9) Which immunization will the nurse provide parental education during the health maintenance visit for a 4-year-old child?

3. Inactive poliovirus #3

6) An adolescent client has a long leg cast secondary to a fractured femur. Which nursing action is most appropriate in order to effectively facilitate the adolescent's return to school?

3. Meet with teachers and administrators at the school to make sure entrances and classrooms are wheelchair accessible.

10) The nurse is conducting a nursing assessment of the parent and child with severe cerebral palsy during a routine clinic visit. Which nursing action is appropriate based on the current data?

3. Observing the parent-child relationship

8) The nurse is assessing an adolescent client during a scheduled health maintenance appointment. Which issues should the nurse address when the parents are not present?

3. Possible domestic violence

16) Which nursing action maintains confidentiality when performing height and weight measurements during a co-ed physical education class?

3. Providing a privacy screen and have the health aid record the findings directly on the record. The nurse will then calculate body mass index

20) A 3-year-old child, recently hospitalized for the exacerbation of a chronic illness, presents for a follow-up appointment at the pediatric clinic. The child's mother states, "He was potty trained before the hospital stay but now he is having daily accidents." Which response by the nurse is most appropriate?

4. "Children often regress after hospitalization. Be patient and remind him to go to the bathroom frequently."

7) Parents of a preschool-age child report that they find it necessary to spank the child at least once a day. Which response by the nurse is appropriate based on this information?

4. "Let's talk about other forms of discipline that have a more positive effect on the child."

3) During a well-child visit with a 4-year-old girl the nurse notes that the parents speaks harshly to the child and used negative remarks when speaking with the nurse. Which statement by the nurse would be beneficial in this situation?

4. "Let's talk privately. We should discuss the way you speak with your child and possible ways to be more positive."

14) The nurse is planning care for a pediatric client who has a fractured femur and requires a spica cast after being involved in a motor vehicle accident. The client's adolescent brother was driving the car, which was a total loss. The client's father lost his job 3 weeks ago and the mother has just accepted a temporary waitress job. Which is an appropriate nursing diagnosis for this child, and family, based on the current data?

4. Compromised Family Coping related to multiple simultaneous stressors.

1) The nurse is providing care to several pediatric clients in the hospital setting. Which client diagnosis is capable of producing chronic limitations for the child?

4. Congenital heart defect

13) Which aspect of an emergency medical services system (EMS) indicates the providers are prepared to provide emergency care to children?

4. Educating staff related to assessment and treatment of children of all ages

18) Which nursing action is appropriate when preparing the family of a school-age child with a chronic illness to provide care in the home setting?

4. Encouraging interaction between the child and others with the same diagnosis

12) An adolescent diagnosed with type 1 diabetes mellitus (DM) is prescribed dietary restrictions and daily insulin injections. Which behavior does the nurse anticipate from the adolescent upon return to school?

4. Exhibiting poor adherence to the prescribed treatment plan

8) In which situation will the school nurse collaborate with the family and other members of the healthcare team in order to develop an individualized health plan (IHP)?

4. For a child who is newly diagnosed with insulin-dependent diabetes mellitus.

23) The nurse is assigned as the care coordinator for a child with special healthcare needs. Which actions by the nurse enhance the family's ability to participate in their child's care coordination? Select all that apply.

4. Helping with decision making for meeting goals of care 5. Educating the family about the diagnosis

13) The nurse is planning health promotion activities for a toddler-age child during a scheduled health maintenance visit. Which action by the nurse is appropriate during this visit?

4. Illustrating developmental progression on a screening tool

2) A community assessment conducted by the nurse reveals that the number of serious injuries in children has doubled in the past year. Which is the most appropriate nursing diagnosis when planning care to address the increased number of injuries?

4. Knowledge Deficit related to injury prevention in children

25) The mother of a 12-year-old child informs the nurse that the child's father died from sudden cardiac death at 44 years old. Which laboratory tests does the nurse anticipate will be prescribed by the healthcare provider?

4. Lipid profile

17) The nurse is planning care for an overweight adolescent. Which topic may also be appropriate for the nurse to include in the adolescent's plan of care?

4. Negative self-esteem

7) Which is the priority topic the nurse will include when teaching newly hired teachers at a child care center within the community?

4. Principles of infection control

21) The nurse learns that a newborn is diagnosed with phenylketonuria (PKU). Which is the most appropriate way to inform the newborn's parents about this diagnosis?

4. Scheduling an appointment for the parents to see the healthcare provider in person to discuss the diagnosis

11) Which screening is appropriate for the school nurse to perform on all adolescent students?

4. Scoliosis

11) A child who has had a tracheostomy for several years is scheduled to begin kindergarten in the fall. The teacher is concerned about this child being in the class, and consults the school nurse. Which nursing action is appropriate?

4. Teaching the teacher how to care for the child in the classroom

5) The visiting nurse is evaluating the home environments of several preschool-age children as they relate to child safety. The nurse visits the home of each child and gathers the following data. Which activity noted during the visit places a child at the greatest risk for bodily harm?

4. The child is permitted to swim in the family pool unsupervised.

3) Which must the nurse realize prior to accepting any assignment as a home health nurse?

4. The family is in charge.

18) The school nurse is assessing an adolescent who reports getting less than 6 hours of sleep at night. Which consequences of inadequate sleep will the nurse include when responding to the adolescent? Select all that apply.

Increased risk of automobile accidents when driving 4. Moodiness 5. An inability to perform well at school

Which is the priority nursing action when performing a physical assessment on a toddler?

Leaving intrusive procedures such as eye and ear examinations until the end

21) The nurse notes dental issues during the assessment of an adolescent client. Which topics will the nurse explore further to determine the cause of the issues? Select all that apply.

Use of a mouth guard when playing physical sports 3. Anorexia nervosa 4. Bulimia nervosa 5. Use of daily vitamins